Ventricular late potential in cardiac syndrome X compared to coronary artery disease
1Department of Physiology, Faculty of Medicine and Health Sciences, Al-Neelain University, Khartoum, Sudan. mohamedfaisallutfi@gmail.com.
Insights
Ventricular late potentials (VLPs) were found to be equally present in patients with coronary artery disease (CAD) and cardiac syndrome X (CSX). This suggests VLPs may not differentiate between these two cardiac conditions.
Area of Science:
- Cardiology
- Electrophysiology
- Diagnostic Medicine
Background:
- Ventricular late potentials (VLPs) are established markers for risk stratification in myocardial infarction (MI) patients.
- Research on VLPs in patients without MI, specifically those with coronary artery disease (CAD) and cardiac syndrome X (CSX), is limited.
- This study addresses the scarcity of comparative data on VLP presence in CSX versus CAD cohorts.
Purpose of the Study:
- To compare the prevalence of ventricular late potentials (VLPs) between patients diagnosed with coronary artery disease (CAD) and those with cardiac syndrome X (CSX).
- To investigate potential differences in VLP occurrence in these two distinct patient groups presenting with cardiac symptoms.
Main Methods:
- Signal-averaged electrocardiography (SAECG) was employed on 49 patients presenting with typical cardiac pain.
- Key ECG parameters including QRS duration, root mean square voltage of the terminal 40 milliseconds (RMS40), and the duration of the terminal part of the QRS complex with low amplitude (LAS40) were analyzed.
- VLP presence was defined by specific criteria (QRS duration >120 ms, RMS40 >38 ms, LAS40 <20 μV). Statistical analyses assessed associations between VLP and patient groups.
Main Results:
- Ventricular late potentials (VLPs) were detected in 11.11% of CAD patients and 15.38% of CSX patients.
- The presence of VLPs was statistically comparable between the CAD and CSX groups (OR=0.69, P=0.692).
- This comparability remained consistent even after adjusting for potential confounding factors like age, gender, BMI, hypertension, and diabetes.
Conclusions:
- The prevalence of ventricular late potentials (VLPs) is similar in patients with cardiac syndrome X (CSX) and coronary artery disease (CAD).
- VLPs do not appear to be a differentiating factor between CSX and CAD in this study population.
- Further research may explore other electrophysiological markers for distinguishing these conditions.
Background:
Although ventricular late potential (VLP) was extensively studied in risk stratification of myocardial infarction (MI) patients, comparable researches evaluating presence of VLP in MI-free coronary artery disease (CAD) and cardiac syndrome X (CSX) subjects are scarce. This study aimed to compare presence of VLP between CSX and CAD patients.
Methods:
Signal average ECG (SAECG) was performed to 49 patients with a history of typical cardiac pain before undergoing diagnostic coronary angiography (DCA) in Al-Shaab cardiac center, Khartoum, Sudan. QRS duration, duration of the terminal part of the QRS complex with amplitude less than 40 microvolts (LAS40) and the root mean square voltage of the terminal 40 milliseconds (RMS40) of the filtered QRS complex were identified for each patient. Presence of two or more of QRS duration > 120 ms, RMS40 > 38 ms and LAS40 < 20 μV was considered indicative of VLP. Associations between VLP and patients grouped according to DCA results were assessed using appropriate statistical tests.
Results:
VLP was present in 11.11% (3.63%-24.66%) and 15.38% (2.66%-42.23%) of patients with CAD and CSX respectively. Presence of VLP was comparable in patients with CAD and CSX (OR = 0.69, 95% CI = 0.11-6.05, P = 0.692), even after controlling for the possible variations in gender, age, body mass index (BMI), hypertension and diabetes mellitus in the studied groups.
Conclusion:
Presence of VLP is comparable among CSX and CAD patients.
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